1215 volume in Sepharose 4B gel filtration; in addition enzyme activities
to
A.P., several other
(y-glutamyl transferase, 5’-nucleotidase, L-leucyl-&bgr;-
are present in this excluded fraction; ultrasonication and n-butanol treatment of this koinozymic fraction results in partial conversion to the more conventional A.P. isozymes also present in the secreted fluid. Ultracentrifugation in ceesium-chloride solution and in sucrose gradient points to a density of 1 195. This koinozymic fraction was treated with 1, 5-glutaraldehyde, concentrated upon a Millipore filter, and incubated for electron-microscopic demonstration of A,P. Vesicles bounded by a triple-layered membrane and membrane fragments, both carrying A.P. activity, were observed, as well as A.P.-negative vesicles (fig. 2). Cytochemistry of tumour tissue revealed both A.P. reactive and non-reactive microvilli.
explain as
some cases
the Letterer-Siwe
of combined
immunodeficiency presenting
syndrome. R. VACCARO
naphthylamidase)
the release of particles from liver-cells. Fragment shedding seems to be not uncommon, and its biological significance deserves further investigation. We have also
seen
Department of Internal Medicine and Clinical Chemistry,
University Hospital, De Pintelaan, Gent, Belgium.
M. DE BROE R. WIEME
Laboratory of Human Anatomy, State University of Gent, Ledeganckstraat, 9000 Gent, Belgium.
F. ROELS
SIR,-We read with interest the letter by Marshall et al.1 reporting the isolation of rubella virus from the skin of a child with congenital rubella and chronic rash. The cause of this uncommon dermal manifestation appearing late in infancy and persisting for many months is not known. We have seen a 14-month-old girl with congenital rubella (diagnosis was based on the persistently high titre of rubella hxmagglutination-inhibiting antibodies in the serum), papular erythematous skin rash, and immunodeficiency. Rubella virus was not isolated from the urine, cerebrospinal fluid, or nasopharyngeal secretions. The rash on the face and extremities first appeared at 2-3 months of age and persisted for 16 months. Skin and lymphnode biopsies showed infiltrates of mononuclear cells, which mimicked the pathological picture of the Letterer-Siwe syndrome. Recurrent diarrhoea and bacterial and fungal infections complicated the course of the illness. A defect of humoral immunity is indicated by the absence of IgA in serum and saliva; no isohxmagglutinins (blood-type A) were detected. T-cell immunity was diminished as shown by the low proportion (45%) of rosette-forming lymphocytes and repeatedly negative skin
(to candida, streptokinase-streptodornase, purified prodinitrochlorobenzene). The in-vitro lymto response phytohæmagglutinin was low phocyte (20xstimulation index). tests
tein derivative, and
Immunological defects were also noted by Claman et al.2 by Hanissian and Hashimoto3 in congenital rubella with
N. FORENZA
Italy.
COFFEE-DRINKING AND MYOCARDIAL INFARCTION
SIR,-Data reported from the Boston Collaborative Drug Surveillance
Program suggest an association between excessive coffee-drinking and myocardial infarction.12 The association could not be attributed to confounding by smoking or by the use of sugar with coffee. In a recent investigation of myocardial infarction in women under the age of 45 years, survivors of infarction and matched control patients were asked about the average number of cups of coffee consumed each day before their hospital admission. Details of the infarction and control patients and the methods of data collection are given elsewhere.3 There was an excess of infarction patients who reported drinking large amounts of coffee each day, representing a two-and-a-half-fold increase in risk among women drinking 6 or more cups daily. Average no. of
RASHES IN CONGENITAL RUBELLA
A. BERTOTTO P. ZUCCHETTI
Istituto di Puericultura, University of Perugia,
cups drunk each
day
No. of M.l. patients
No. of controls
Comparison between proportions of patients drinking 6 or more compared with those drinking fewer than 6 cups: &khgr;12 = 4.7; p
to
A.P., several other
(y-glutamyl transferase, 5’-nucleotidase, L-leucyl-&bgr;-
are present in this excluded fraction; ultrasonication and n-butanol treatment of this koinozymic fraction results in partial conversion to the more conventional A.P. isozymes also present in the secreted fluid. Ultracentrifugation in ceesium-chloride solution and in sucrose gradient points to a density of 1 195. This koinozymic fraction was treated with 1, 5-glutaraldehyde, concentrated upon a Millipore filter, and incubated for electron-microscopic demonstration of A,P. Vesicles bounded by a triple-layered membrane and membrane fragments, both carrying A.P. activity, were observed, as well as A.P.-negative vesicles (fig. 2). Cytochemistry of tumour tissue revealed both A.P. reactive and non-reactive microvilli.
explain as
some cases
the Letterer-Siwe
of combined
immunodeficiency presenting
syndrome. R. VACCARO
naphthylamidase)
the release of particles from liver-cells. Fragment shedding seems to be not uncommon, and its biological significance deserves further investigation. We have also
seen
Department of Internal Medicine and Clinical Chemistry,
University Hospital, De Pintelaan, Gent, Belgium.
M. DE BROE R. WIEME
Laboratory of Human Anatomy, State University of Gent, Ledeganckstraat, 9000 Gent, Belgium.
F. ROELS
SIR,-We read with interest the letter by Marshall et al.1 reporting the isolation of rubella virus from the skin of a child with congenital rubella and chronic rash. The cause of this uncommon dermal manifestation appearing late in infancy and persisting for many months is not known. We have seen a 14-month-old girl with congenital rubella (diagnosis was based on the persistently high titre of rubella hxmagglutination-inhibiting antibodies in the serum), papular erythematous skin rash, and immunodeficiency. Rubella virus was not isolated from the urine, cerebrospinal fluid, or nasopharyngeal secretions. The rash on the face and extremities first appeared at 2-3 months of age and persisted for 16 months. Skin and lymphnode biopsies showed infiltrates of mononuclear cells, which mimicked the pathological picture of the Letterer-Siwe syndrome. Recurrent diarrhoea and bacterial and fungal infections complicated the course of the illness. A defect of humoral immunity is indicated by the absence of IgA in serum and saliva; no isohxmagglutinins (blood-type A) were detected. T-cell immunity was diminished as shown by the low proportion (45%) of rosette-forming lymphocytes and repeatedly negative skin
(to candida, streptokinase-streptodornase, purified prodinitrochlorobenzene). The in-vitro lymto response phytohæmagglutinin was low phocyte (20xstimulation index). tests
tein derivative, and
Immunological defects were also noted by Claman et al.2 by Hanissian and Hashimoto3 in congenital rubella with
N. FORENZA
Italy.
COFFEE-DRINKING AND MYOCARDIAL INFARCTION
SIR,-Data reported from the Boston Collaborative Drug Surveillance
Program suggest an association between excessive coffee-drinking and myocardial infarction.12 The association could not be attributed to confounding by smoking or by the use of sugar with coffee. In a recent investigation of myocardial infarction in women under the age of 45 years, survivors of infarction and matched control patients were asked about the average number of cups of coffee consumed each day before their hospital admission. Details of the infarction and control patients and the methods of data collection are given elsewhere.3 There was an excess of infarction patients who reported drinking large amounts of coffee each day, representing a two-and-a-half-fold increase in risk among women drinking 6 or more cups daily. Average no. of
RASHES IN CONGENITAL RUBELLA
A. BERTOTTO P. ZUCCHETTI
Istituto di Puericultura, University of Perugia,
cups drunk each
day
No. of M.l. patients
No. of controls
Comparison between proportions of patients drinking 6 or more compared with those drinking fewer than 6 cups: &khgr;12 = 4.7; p
